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      • 인지장애노인의 요실금에 대한 고찰

        류세앙 동신대학교 2006 論文集 Vol.16 No.-

        This research was performed to review on urinary incontinence of the cognitively impaired older adults. There was use of diaper or habits practice for a management of urinary incontinence that is one of major problem in nursing at the long term care facilities, which could lead to a physical and emotional problem of the patients and caregivers. Self-management strategies like pelvic muscle exercise and biofeedback were proved the effectiveness on urinary incontinence who were the cognitively intact and ambulatory adult. However it is difficult to apply those for the cognitively or physically impaired elderly as the strategies need cognitive ability for learning and performing, Because of this limitation, caregiver-dependent strategies like scheduled toileting, habit training and prompted voiding are usually recommended for management of urinary incontinence of the cognitively impaired older adults. Prompted voiding involves asking residents at regular intervals if they need to void and if so, they are helped in toileting, which is to assist them to void using appropriate toileting receptacles before the resident urinate involuntarily on the clothing, bed or diaper. So it has advantage of involving the elderly in decision making of their care, and has merit of keeping dignity of individual as they maintain almost normal voiding. Conclusively, this implies that the individual could maintain a certain level of continence if appropriate toileting opportunity given, although the elderly has impaired cognition and mobility. But, Important factors of successful implementation of prompted voiding were as followed. First, there must be a subject selection process for appropriate for prompted voiding. Second, identify subject's voiding pattern and schedule individually. Lastly, give a positive feedback, when the resident request toileting assistance, or maintain continence status, or use toileting receptacles properly. I hope to develope a practical prompted voiding protocol based on this results and to perform it for cognitively and physically dependent older adults.

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